Hamid Hassan Flashcards

1
Q

The salivary glands are exocrine merocrine glands, define exocrine and merocrine

A

Exocrine: secrete products through ducts opening onto epithelium
Merocrine: no part of cell lost during secretion by using vesicles and exocytosis

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2
Q

What type of fibres stimulate salivary secretion

A

Parasympathetic reflexes

Sympathetic stimulation

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3
Q

What is the acini

A

Secretory unit producing saliva

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4
Q

What is the pathway of the salivary gland and cell types throughout

A

Acinar cells cluster around lumen
Lumen empties into intercalated duct lined with simple cuboidal epithelium
Empties into striated duct of simple columnar
Empties into excretory duct of stratified cuboidal
Empties into collecting duct of stratified cuboidal

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5
Q

What is the difference in staining of serous and mucous acinar

A

Serious have basophilic secretory vesicles around lumen and are acidic so stain purple with HandE

Mucous stain paler with h and e

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6
Q

What are myoepithelial cells

A

Epithelial cells with muscular features that lie between basal lamina and basal membrane of acinar cells and intercalated duct

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7
Q

What do myoepithelial cells do

4

A

Reduce back flow of saliva
Accelerate outflow
Reduce luminar volume
Increase secretory pressure

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8
Q

What is a key feature of striated duct structure

2

A

Basal surface has foldings with mitochondria for energy to aid active transport
Luminar surface has microvilli to increase SA

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9
Q

What occurs in striated duct to make saliva hypotonic

A

Reabsorbtion of Na and Cl

Secretion of k and HCO3

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10
Q

How is the parotid gland divided
What is it’s duct called
Where does it’s duct empty

A

Deep part and superficial part divided by facial nerve
Stensons
Upper 2nd molar

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11
Q

What is blood supply to parotid gland

A

External carotid artery

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12
Q

What is the venous drainage of the parotid gland

A

External jugular vein

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13
Q

What structure is superior to parotid gland

A

TMJ

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14
Q

What structure is posterior to parotid gland

A

Mastoid process

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15
Q

What structure is anterior to parotid gland

A

Angle of mandible
Medial pterygoid plate
Massater
Stylomandibular ligament

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16
Q

What saliva is produced by submandibular gland

What is it’s duct and where does it drain

A

Mixed

Wartons
Lingual frenulum

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17
Q

How is the submandibular gland divided

A

Superficial part below mylohyoid and deep part above mylohyoid

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18
Q

What is the blood supply to submandibular gland

2

A

Submental artery

Sublingual artery

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19
Q

What is the venous drainage of submandibular gland

A

Submental vein into facial vein into internal jugular vein

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20
Q

What saliva is secreted by sublingual gland

What is it’s duct called and where does it empty

A

Mucous saliva
Bartholins
Several openings in floor of mouth

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21
Q

What is the blood supply of sublingual gland

2

A

Submental artery

Sublingual artery

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22
Q

What is the venous drainage of sublingual gland

A

Submental vein into facial vein into internal jugular vein

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23
Q

What is the most common type of minor salivary glands

Why is saliva from minor salivary duct high in sodium

A

Mucous

No intercalated or striated duct

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24
Q

Where are glands of Von ebner

What type of saliva do they produce

A

Circumvallate papillae

Serous

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25
Where are mucous minor salivary glands found | 3
Hard palate Soft palate Lingual tonsils
26
Where are serous minor salivary glands found
Lingual sulcus terminalis in circumvalate papillae
27
Where are mixed minor salivary glands found
Tip of tongue
28
What nerve innervates the parotid gland and what is it’s pathway to the parotid gland
Parasympathetic innervation from lesser petrosal nerve of glossopharyngeal Inferior Salavitory nucleus in medulla Through jugular foramen Through tympanic canuliculus into middle ear Out of middle ear and through hiatus of lesser petrosal nerve into middle cranial fossa Through foramen ovale Otic ganglion to parotid gland
29
What nerve innervates submandibular and sublingual glands | What is it’s pathway
Parasympathetic innervation via chorda tympani of facial nerve Superior salavotory nucleus in pons Through internal acoustic meatus as facial nerve to middle ear Chorda tympani given off Lingual nerve of V3 joins chorda tympani Submandibular ganglion to SM and SL glands
30
What provides sympathetic innervation to the salivary glands What is it’s pathway
``` T1-T4 Thoracic vertebrae 1-4 Super cervicular ganglion Internal carotid plexus Deep petrosal nerve SM SL and Parotid glands ```
31
How much saliva is produced a day | What % saliva is water
1-1.5 l | 99%
32
What is whole saliva composed of | 6
``` Saliva Epithelial cells Neutrophils Lymphocytes Bacteria GCF ```
33
What are the roles of saliva | 11
``` Buffering Pellicle formation Remineralisation Salivary proteins Clensing Immunity Lubrication Digestion Taste Water balance Wound healing ```
34
What is the component in saliva responsible for buffering | What’s its concentration in stimulated and unstimulated saliva
Bicarbonate Unstimulated 1mmol per litre Stimulated 60mmol per litre
35
What reaction allows bicarbonate to buffer
HCO3- ➕ H+ ➡️ H2CO3 ➡️ H2O ➕ CO2
36
How thick is the pellicle What does it do 2
1-10 micrometers Diffusion barrier Base of adhesion
37
How does saliva aid remineralisation
Increases concentration of ions available to remineralise hydroxyapatite
38
What are the salivary proteins in saliva | 4
Statherin Proline rich proteins Cystatins Histatins
39
What does statherin do
Prevents precipitation of calcium phosphate to maintain high calcium availability for remineralisation
40
What do proline rich proteins do | 2
Maintain concentration of calcium in saliva by binding to it and adsorbing to hydroxyapatite surface Inhibit hydroxyapatite growth
41
What do cystatins do
Inhibit proteases of periodontal disease
42
What do histatins do
Antimicrobial proteins that assist homeostasis and help pellicle formation
43
How does saliva repair early caries
Inhibitors in saliva prevent crystal growth in enamel on surface of lesion to keep pores open for remineralisation
44
How does saliva cleanse the oral cavity
Washes away noxious agents, bacteria and food debres to the gut
45
What is the role of IgA
Limits microbial adherence and agglutinate bacteria
46
Where is IgG derived from
GCF
47
What does lysozyme do
Breaks down bacteria walls
48
What does lactoferrin do
Binds to ions and inhibits Bacteria growth with lysozyme
49
What do mucins do | What glands are they derived from
Aggregate bacteria | sublingual, submandibular and minor salivary glands
50
What do histatins do
Helps form pellicle and inhibits candida albicans
51
What do defensins do
Aggregate bacteria and integrate into lipid bilayer to disrupt
52
How does saliva aid digestion
Amylase from parotid gland helps break down starch by hydrolising alpha 1,4 linkages into maltose and dextrin
53
How does saliva aid body water balance
When we are dehydrated saliva rate decreases causing dry mouth which stimulates tactile receptors which send impulses to hypothalamus to create conscious awareness of thirst
54
What is normal unstimulated flow
0.3-0.4 ml/min
55
What is normal stimulated flow
1-3ml / min
56
What is unstimulated flow in xerostoma
Below 0.1 ml /min
57
What is stimulated flow rate in xerostomia
Below 0.7ml / min
58
What drug is used for xerostoma
Pilocarpine
59
What are the main organs of GI tract | 5
``` Oral cavity Oesophagus Stomach Small intestine Large intestine ```
60
What are the accessory organs of the GI tract | 6
``` Teeth Tongue Salivary glands Liver Gall bladder Pancrease ```
61
What is the pH of the oral cavity
5-7
62
What type of epithelium line esophagus
Non keratinised stratified squamous
63
What are the laters of wall lining GI tract | 4
Adventia / serosa Muscularis externa Submucosa Mucosa
64
What is the difference between serosa layer or adventia layer
Serosa is slippery and serous, adventia is thick and fibrous
65
Where is serosa found | 6
``` Stomach Spleen Liver Duodenum Transverse colon Sigmoid colon ```
66
Where is adventia found | 5
``` Duodenum Cecum Ascending colon Descending colon Pancrease ```
67
What are the layers of muscularis externica and what do they do 3
Outer longitudinal- relaxes and lengthens to pull food forward Myenteric plexus- causes smooth muscle relaxation when activated Inner circular- contract and constrict behind food
68
What are the layers in mucosa in GI tract | 3
Epithelial layer Lamina propria Muscularis mucosa
69
What is the role of liver in relation to GI tract
Makes bile
70
What are the muscle layers in muscularis externica of the stomach 3
Longitudinal Circular Oblique
71
What is the pH of the stomach | How long is food in stomach
pH1-3 | 30mins to 4 hours
72
What are the sphincters of the stomach
Cardiac sphincter | Pyloric sphincter
73
What are the areas of the stomach | 5
``` Cardia Fundus Body Pyloric atrium Pyloric canal ```
74
What are the cells of the stomach lining and gastric pits and what do they secrete 5
``` Surface mucous cell : mucous Mucous neck cell : mucous Parietal cell : HCl Chief cell : pepsinogen Neuroendocrine cell ```
75
What hormone triggers release of bile from gall bladder
CCK
76
What does bile do
Emulsifies fad in lipid digestion
77
What is the endocrine function of the pancrease
Alpha cells secrete glucagon | Beta cells secrete insulin
78
What is the exocrine function of the pancrease
Acini secretes HCO3, tyripsinogen, nucleases, proteases, chymotripsinogen, amylase and lipase Into interlobular duct Into pancreatic duct
79
What is the optimum pH of pancreatic amylase
5.6-6.9
80
How does bile and pancreatic juice enter the duodenum
Hepatopancreatic sphincter
81
What is the ph of the small intestine | How long is food in the small intestine
pH 6-7.5 | 1-2 hours
82
What are the cells of the small intestine and what is there function 5
Enterocyte- absorbtion Goblet cells- mucus secretion Enteroendocrine cells- hormone secretion Paneth cells- synthesis ofantimicrobial peptides M cells- antigen presenting
83
Where are proliferating cells of small intestine found
Crypt of epithelium
84
What are the sections of the small intestine
Duodenum Jejunum Ileum
85
What are brunners glands, where are they and what do they do
Found in duodenum and increase pH between stomach and small intestine
86
Which segments of the small intestine have circular folds
Jejunum | Ilium
87
What are payers patches and where in GI tract are they found
Payers patches are an aggregation of lymphocytes for immune response found in the ilium
88
Where is B12 absorbed
Ilium
89
How are fatty acids and glycerol absorbed
``` Oral cavity- lingual lipase Stomach- gastric lipase Pancrease secretes bile and pancreatic lipase into duodenum Bile emulsifies lipids into miscelle Miscelle absorbed into enterocyte Through SER and RER Exocytosis of chylomicron into lactiles ```
90
How are proteins absorbed
Chief cells secrete pepsinogen which is converted to pepsin by HCl secreted by parietal cells In duodenum CCK causes protease release into small intestine from pancrease In small intestine brush border enzymes secrete peptidases Amino acids and small peptides absorbed into enterocyte
91
How are carbohydrates absorbed
In oral cavity amylase secreted CCK causes pancreatic amylase release into duodenum In small intestine brush border enzymes on microvilli- lactase, Maltase, sucrase Monosaccharides absorbed into enterocyte through GLUT5 and SGLT transporters GLUT 2 transporters into intestinal capillaries to hepatic portal vein
92
What is the pH of the large intestine | How long does food stay in large intestine
pH 5-7 | 12-24 hours
93
What is absorbed in the large intestine 4
Water Fibre Bile salts Vitamins
94
Which vitamins are absorbed in large intestine | 3
K Biotin B7 B5
95
What are the sections of the large intestine
``` Cecum Ascending colon Right colic fletcture Transverse colon Left colic flecture Descending colon Sigmoid colon ```
96
How does food pass from small to large intestine
Iliocecal sphincter
97
What are hastura and what do they do What are tendiniae coli and what do they do What are omental appendices and what do they do
Bubbles of large intestine which mix chyme and move food along Longitudinal ribbons of smooth muscle that contract to produce hastara Small pouches of fat with unknown function
98
Define physiological stress
The response of an organism to stressors with sympathetic and parasympathetic activity leading to physiological and behavioural responses
99
Define excercise stress
Changes in body to deal with demands of physical activity
100
What is the different between acute and chronic stress
Acute stress has short term responses whereas chronic stress is ongoing with damaging effects
101
What is the physiology of stress | 5
Stress detected Amygdala in brain stimulates hypothalamus Hypothalamus activates sympathetic nervous system of ANS Signals to adrenal medulla which secrete adrenaline and noradrenaline, signals to visceral effectors (smooth muscle, cardiac muscle m, glands) Outcome
102
What are the stress hormones and what do they do? | 5
Corticotropin releasing hormone: stimulates ACTH release Adrenocorticotropic hormone: stimulates cortisol release Cortisol: gluconeogenesis, proteolylis, reduces inflammation, surpression of immune system,reduced wound healing, reduced bone formation Growth hormone releasing hormone: causes release of growth hormone from pituitary Thyrotropin releasing hormone: causes secretion of thyroid stimulating hormone from pituitary gland
103
``` Where is corticotropin releasing hormone released Adrenocorticotropic hormone Cortisol Growth hormone releasing hormone Thyrotropin releasing hormone ```
``` Hypothalamus Pituitary gland Adrenal cortex Hypothalamus Hypothalamus ```
104
What is the physiology of excercise stress | 8
Excercise Oxygen and energy demand to muscles increases ATP stores in muscles used up so more ATP made from creatine phosphate and ADP via anaerobic and aerobic respiration In CV system sympathetic nervous system increases heart rate and has positive ionotrophic effect Vasodilation in muscles increases oxygen delivery Ventilation increases as increasing levels of CO2 are detected Cortisol is released Antidiuretic hormone and aldosterone are released to conserve water
105
What are the oral diseases associated with stress | 7
``` Periodontal disease Bruxism Oral lichen planus TMJ PDS Recurrent aphthous ulcer Acute necrotising ulcerative gingivitis Dry mouth ```
106
What is normal blood glucose
4.4-6.1 mmol/L
107
What is hyperglycaemia level
Above 11.1 mmol/L
108
What is hypoglycaemia level
Below 2.8 mmol /L | Below 3.9 mmol /L in diabetic
109
How does the body respond to high blood glucose | 6
High blood sugar detected by beta cells in islets of langerhan which produce insulin Insulin binds to complementary receptors on muscle and liver More GLUT4 transporters embedded into plasma membrane for facilitated diffusion of glucose In liver enzymes activated to cause glycogenesos Insulin increases cellular respiration Insulin promotes synthesis of proteins and fatty acids and inhibits breakdown of adipose
110
How does the body respond to low blood glucose | 6
Alpha cells in islets of langerhan produce glucagon Glucagon binds to receptors on liver Enzymes activated for gluconeogenesis Enzymes activated for glycogenolysis Facilitated diffusion of glucose out of liver into bloodstream Glucagon reduces fatty acid synthesis and promotes lipolysis of adipose tissue
111
Which hormones other than insulin lower blood glucose and what secretes them 3
Amylin secreted by beta cells GLP1 secreted by intestinal endocrine L cells Somatostatin secreted by delta cells of pancrease
112
Which hormones other than glucagon raise blood sugar and what secretes them 6
``` Asprisin- white adipose Epinephrine- adrenal medulla Cortisol- adrenal cortex Adrenocorticotropic hormone- pituitary gland Growth hormone- pituitary gland Thyroxine-thyroid ```
113
What is type one diabetes and what percentage of diabetics are type 1
Body can’t produce enough insulin due to autoimmune attack of beta cells in pancrease caused by genetics with environmental influences 9%
114
What are the symptoms of type 1 and 2 diabetes | 5
``` Polyurea Polydipsea Polyphagia Fatigue Weight loss ```
115
How is type 1 diabetes treated
Insulin Lifestyle management Diet management
116
What are complications of type 1 and 2 diabetes | 4
CV disease Diabetic retinopathy Lower limb damage Kidney failure
117
What is type 2 diabetes and how many diabetics are type 2
Ineffective use of insulin leading to insulin resistance caused by lifestyle with genetic factors 90%
118
What are the treatments for type 2 diabetes | 4
Increased excercise Weight loss Low glycemic index diet Metformin to reduce gluconeogenesis
119
What are the symptoms of low blood sugar | 8
``` Trembling Heart pounding Sweating Hunger Numbness Sleepiness Irritability Headache ```
120
What are the symptoms of very low blood sugar | 5
``` Confusion Blurred vision Difficulty speaking Seizures Coma ```
121
What is the lifespan of receptor cells of taste buds
10 days
122
How are salty tastes transduced
Sodium ions diffuse through protein channels into type 1 cells causing depolarisation Depolarisation causes voltage gated calcium ion channels to open and calcium enters cell causing vesicles to release neurotransmitter Neurotransmitter creates action potential in nerve fibres
123
How are sour tastes transduced
Hydrogen ions diffuse into type 3 cells through protein channels leading to depolarisation Voltage gated calcium ion channels open and calcium enters Vesicles release neurotransmitter causing action potential in nerve
124
How are bitter, umami, sweet tastes transduced
Tastants bind to G protein coupled receptors which are linked to transducin Transducin binds to phospholipase c and activated it Phospholipase c breaks down PIP2 into DAG and IP3 IP3 causes calcium release from SER Calcium and IP3 open TRPM5 ion channels so sodium and potassium can enter cell and cause depolarisation
125
What is the difference between the orthonasal and retronasal pathway
Orthonasal through nostril to olfactory epithelium | Retronasal through mouth and nasopharynx to olfactory epithelium
126
What do warm receptors detect | What do cold receptors detect
Heating up | Cooling down
127
What is stress a risk factor of | 2
Heart attack | Periodontal disease
128
What is poor diet a risk factor of | 4
Obesity Cancer Heart disease Caries
129
What is smoking a risk factor of | 4
Cancer Heart disease Respiratory disease Periodontal disease
130
What is alchohol a risk factor of | 2
Heart disease | Trauma
131
What is low excercise a risk factor of | 2
Obesity | Heart disease
132
What is poor hygiene a risk factor of | 1
Periodontal disease
133
What are fat souluble vitamins | Which vitamins are these
Vitamins absorbed with fats in the diet that can be stored in the bodies fatty tissues A D E K
134
What are water soluble vitamins | Which vitamins are water soluble
Vitamins that can dissolve in water and are not stored in the body B1 B2 B3 B5 B6 B7 B9 B12 C
135
What is the name of vitamin A | What does it do (4)
Retinoids Growth of epithelium Component of pigment in rod cells Maintains oral mucosa Antioxidant prevents oral cancer
136
Where is vitamin A found (2) What does it’s defficiency cause (3)
Beta carotene is it’s provitamin Dark green, yellow and red vegetables Night blindness with softening cornea Periodontal disease Enamel and dentine hypoplasia
137
What does vitamin A toxicity cause | 7
``` Headaches Double vision Dizziness Bone and joint pain Hair loss Dermatitis Teratogenic ```
138
What is vitamin B1 called | What does it do
Thiamin | Carbohydrate metabolism and production of HCl in stomach
139
Where is B1 found (5) | What does B1 deficiency cause (5)
``` Peas Fruit Eggs Whole grain bread Fortified cereal ``` ``` Loss of apetite Constipation Nausea Confusion Beriberi ```
140
What are the effects of beriberi
Cardiac failure | Oedema
141
What is vitamin B2 called What does it do
Riboflavin Helps metabolise lipids and carbohydrates and produce B3 and B6
142
Where is vitamin B2 found 6 | What does vitamin B2 deficiency cause 4
``` Mushroom Cornflakes Yeast Liver Fish Eggs Pork ``` Scaly dermatitis Photophobia Glossitis Angular cheilitis
143
What is vitamin B3 called | What does it do
Niacin | Forms part of coenzymes NAD and NADP and used to synthesise fats and sugars
144
Where is vitamin B3 found (7) | What does B3 deficiency cause (4)
``` Yeast Meat Fish Milk Eggs Green vegetables Made from amino acid tryptophan ``` Pellagra Diorrhea Dermatitis Dementia
145
What is vitamin B12 called | What does it do
Cobalamin Converts homocysteine to methionine which is an essential amino acid and helps make dna and maintain nerve cells and synthesise red blood cells
146
What does B12 require to be absorbed in the ileum
Intrinsic factor from parietal cell of stomach
147
Where is B12 found | What does B12 deficiency cause (5)
Animal products ``` Anamea Weight loss Fatigue Confusion Dementia ```
148
What is pernicious anaemia
Autoimmune disease caused by gastric atrophy and loss of intrinsic factor so B12 can’t be absorbed in ileum
149
What is vitamin B9 called | What does it do
Foliate/folic acid | Helps break down homocysteine to methionine and is important in gene expression
150
Where is B9 found (4) | What does B9 deficiency cause
Beans Citrus fruit Whole grain Green leafy vegetables Birth defects and premature birth
151
What is vitamin c called | What does it do
Ascorbic acid | Antioxidant that protects against cancer and is used to make collagen
152
Where is vitamin c found | What does deficiency cause (6)
Citrus fruits ``` Fragility Bleeding Muscle weakness Fatigue Malaise Scurvy ```
153
What are the oral effects of scurvy | 3
Gingival bleeding and swelling Loose teeth Compromised immune function
154
What is vitamin D called | What does it do
Ergocalciferol | Helps metabolise calcium and phosphate in bone and moderates immune system
155
Where is vitamin D found (3) | What does vitamin d deficiency cause
Egg yolks Fish liver oils Sunshine Rickets or osteomalacia
156
What are the symptoms of rickets or osteomalacia? 7
``` Pain Skeletal deformities Poor growth Fragile bones Richitic teeth Delayed eruption Increased caries risk ```
157
What is vitamin K called | What does it do
Phytonadione | Regulates blood clotting and bone metabolism and blood calcium levels and counteracts warfarin
158
Where is vitamin K found | What does vitamin k deficiency cause
Green leafy vegetables and synthesised by colonic bacteria Easy bruising and excessive bleeding
159
What is kwashiorkor
Severe protein malnutrition
160
What are the cariostatic minerals | 5
``` Molybdenum Vanadium Fluoride Strontium Lithium ```
161
What are the caries promoting minerals | 3
Selenium Cadmium Lead
162
What are the branches of the common carotid artery Where does is bifurcate
Internal carotid artery External carotid artery C4
163
What is the mnemonic for branches of external carotid artery
``` Some Anatomists Like Freaking Out Poor Medical Students ```
164
What are the branches of external carotid artery and where do they supply 8
Superior thyroid- larynx and thyroid Ascending pharyngeal artery- soft palate and pharynx Lingual artery- tongue Facial artery- lower face Occipital artery- occipital region Posterior auricular artery- skin over mastoid and middle ear Maxillary artery- ear, alveolus, pterygoid muscles, temporalis, palate, nasal, pharynx Superficial temporal artery- temporal region
165
What is the pathway of ascending pharyngeal artery
Branches into 3 One branch through foramen lacerum One branch through jugular foramen One branch through hypoglossal canal
166
Where does the lingual artery arise | What nerve is it crossed by
Tip of greater horn of hyoid | Hypoglossal n
167
Where does the facial artery arise | What is it’s pathway
``` Arises just above greater horn of hyoid Runs upwards on superior constrictor muscle S turn curls around submandibular gland Gives off submental artery Crosses mandible ```
168
What is the pathway of posterior auricular artery
Arises above digastric muscle Supplies skin over mastoid process Branches to middle ear
169
What is the pathway of the maxillary | 4,3,6
Enters infra temporal fossa Gives off inferior alveolar, middle meningeal, accessory meningeal and ear branch Passes between superior and inferior heads of lateral pterygoid muscle Gives off medial pterygoid, lateral pterygoid and temporalis branch Passes through pterygomaxilary fissure into pterygopalatine fossa Gives off naso palate, anterior palatine, middle palatine, posterior palatine, posterior superior lateral nasal branch and pharyngeal branch
170
Where does the superficial temporal artery branch from | What is it’s pathway
Parotid gland Passes over zygomatic process of temporal bone Divides into frontal branch and parietal branch
171
What artery supplies central mandible
Inferior alveolar artery
172
What artery supplies peripheral mandible
Facial artery
173
Which areas drain into the retro mandibular vein | 2
Superficial temporal vein | Maxillary vein
174
What drains into the external jugular vein | 4
Posterior auricular Retro mandibular Posterior external jugular Transverse cervical
175
What drains into the subclavian vein | 3
External jugular vein Anterior jugular vein Internal jugular vein
176
What drains into internal jugular vein | 7
``` Sigmoid sinus Inferior petrosal sinus Facial vein Lingual vein Occipital vein Superior thyroid vein Middle thyroid vein ```
177
Where does the subclavian vein drain into
Superior vena cava